Degenerative Disc Disease: Causes, Symptoms, and Treatment
Degenerative disc disease means age-related wear of the discs that cushion your spine. It is common. It is not always painful. When it does hurt, care starts with a clear exam. Treatment matches your pattern—not every MRI finding.
Quick Answer: Degenerative Disc Disease
- Disc wear is common with age; MRI changes alone do not equal a diagnosis.
- Symptoms may stay in the neck or low back, or travel if a nerve is irritated.
- First-line care is activity change, therapy, and medicines when safe.
- Discogenic pain and vertebrogenic pain are different and need different plans.
- Biologic disc injections are not FDA approved for this use; evidence is still developing.
- Fever, unexplained weight loss, bowel/bladder loss, or progressive weakness need urgent care.
What Degenerative Disc Disease Means
Discs lose water and spring over years. Height can drop. The outer ring can develop small tears. Many adults show these changes without symptoms [Source]. When symptoms occur, people often feel deep midline neck or low back pain. Sitting, bending, or lifting can flare it. Walking or a position change can ease it.
Cervical vs Lumbar Patterns
In the neck, disc wear may cause stiffness, shoulder-blade pain, or arm tingling if a root is irritated. In the low back, pain often stays in the center. It can also add to stenosis or sciatica when nerves are crowded. Related reading: back pain, annular tear, and spinal stenosis treatment.
Discogenic vs Vertebrogenic Pain
Discogenic pain comes from the disc, especially the outer ring. Vertebrogenic pain comes from inflamed bone endplates. It links to Modic type 1 or 2 changes on MRI. Selected vertebrogenic cases may be treated with basivertebral nerve ablation (for example, the OptaBlate or Intracept systems) [Source]. Mixing these labels leads to the wrong procedure. Your doctor uses history, exam, and MRI features together.
Risk Factors and Symptoms
- Age, family traits, smoking, heavy loading, and prior injury raise risk of painful wear.
- Central neck or low back pain that flares with bending or sitting is a common discogenic story.
- Arm or leg nerve symptoms suggest more than the disc alone.
How Degenerative Disc Disease Is Diagnosed
History and exam come first. MRI shows water content, height, herniation, and endplate changes. Asymptomatic findings are common. Provocative discography is controversial and used sparingly. The goal is to match your pain behavior to structures that can explain it. We do not “treat the MRI.”
First-Line Care for Degenerative Disc Disease
Keep gentle motion. Avoid full bed rest. Physical therapy builds endurance and movement confidence. Weight care and quitting smoking support disc nutrition when relevant. Short courses of anti-inflammatory medicine may help flares when safe. Chiropractors and physical therapists can be partners for mobility when appropriate.
Simple pacing helps. Break up long sits. Use a lumbar roll if it helps. Switch tasks before pain spikes. Sleep with a supportive mattress and a pillow that keeps your neck neutral if neck discs are involved.
Injections and Procedures
Epidural steroid injections may calm nerve-root inflammation when radicular features are present. They do not reverse disc wear. For selected vertebrogenic patterns with Modic changes, basivertebral nerve ablation (OptaBlate or Intracept) may be discussed. Older intradiscal heat procedures such as IDET are rarely first-line today [Source].
Some patients ask about biologic injections into the disc, such as PRP. These are not FDA approved for this use and evidence is still developing; your doctor can explain whether any option fits your diagnosis. Wharton’s jelly–derived products, when discussed, carry the same FDA and evidence caveats.
Keep a short list of positions that help and hurt. Sitting tolerance, morning stiffness, and night pain each tell a different story. Share that list at your visit so the plan matches your day, not only your scan.
If symptoms travel into an arm or leg with numbness or weakness, say so early. That pattern can change which injection or imaging step comes next.
Dr. Amit Sharma & our minimally invasive pain & spine team.
Bring prior MRIs and a list of therapies already tried. That history prevents repeat steps and focuses on safer next options.
If arm or leg strength is fading, or if pain wakes you every night with fever, do not wait for a routine follow-up. Those patterns need faster review.
When Surgery Is Discussed
Progressive weakness, severe stenosis with nerve loss, instability, or failed reasonable non-surgical care may lead to a surgical visit. Fusion is not the first step for most discogenic pain. Motion-preserving and less invasive options are weighed against your goals and risks.
Care at SpinePain Solutions
At SpinePain Solutions, Dr. Amit Sharma, Chief, Division of Pain Medicine at Good Samaritan University Hospital, evaluates degenerative disc disease at our Bay Shore, Commack and Farmingdale offices (see office locations). Call 631-310-0000.
Frequently Asked Questions
What is degenerative disc disease?
Degenerative disc disease describes age-related wear of the cushions between vertebrae. Discs lose water and height over time. Many people have disc changes on MRI without pain. When pain occurs, it is often called discogenic pain.
When is degenerative disc disease an emergency?
Seek urgent care for fever with severe back pain, unexplained weight loss, bowel or bladder loss, saddle numbness, or progressive leg weakness. Those are not routine disc-wear symptoms.
Is degenerative disc disease the same as vertebrogenic pain?
No. Discogenic pain comes from the disc itself. Vertebrogenic pain comes from inflamed vertebral endplates and is linked to Modic changes on MRI. Treatments differ.
Do MRI findings alone decide treatment?
No. Degenerated discs are common in people with no pain. Treatment follows your symptoms, exam, and how imaging matches your story.
What treatments help first?
Most people start with activity changes, physical therapy, and short courses of anti-inflammatory medicine when safe. Epidural steroid injections may help when nerve irritation is present.
What about biologic injections into the disc?
Some patients ask about biologic injections into the disc, such as PRP. These are not FDA approved for this use and evidence is still developing; your doctor can explain whether any option fits your diagnosis.
When is surgery considered?
Surgery is discussed when severe nerve compression, progressive weakness, or instability persists after a fair try of non-surgical care—or when red-flag findings require it.
Where can I get care for degenerative disc disease on Long Island?
SpinePain Solutions evaluates degenerative disc disease and related spine pain in Bay Shore, Commack and Farmingdale. Call 631-310-0000.
Dr. Amit Sharma & our minimally invasive pain & spine team.
Medical References
- Helm S et al. Systematic review of the effectiveness of thermal annular procedures in treating discogenic low back pain. Pain Physician. 2009. PMID 19165305.
- Peng BG et al. Pathophysiology, diagnosis, and treatment of discogenic low back pain. World J Orthop. 2013. PMID 23610750.
- Brinjikji W et al. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR Am J Neuroradiol. 2015. PMID 25430861.
- Fischgrund JS et al. Intraosseous basivertebral nerve ablation for the treatment of chronic low back pain: a prospective randomized double-blind sham-controlled multi-center study. Eur Spine J. 2018. PMID 29423885.
